The research will examine an innovative management mechanism which has been adopted by a few large hospitals to improve coordination of services. Triad Management Systems charge an administrator, nurse and physician with joint responsibility for management of a hospital unit. In this research coordination is considered a dependent variable occurring at the unit level. The research design is a comparative case study. Two Triad managed units of a medical school hospital will be compared to similar but hierarchically organized units in a comparable hospital. Data will be collected via non-participant observation, interviews and questionnaires. The research will examine in particular how Triad members relate task uncertainty, coordination modes, and conflict resolution modes in a setting of strong parochial external norms. Data from the primary study hospitals will be compared to data obtained from four other hospitals which use or have used some form of Triad Management. This research will develop a systemic explanation of what makes a Triad work well or poorly, will provide a theoretical background to improve the technology or organization design, and, more specifically, will provide guidelines for design of unit level coordination mechanisms.